Organization
EXTRAORDINARY ABA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAMIN SEDIQI (DIRECTOR OF OPERATIONS)
(858) 790-2334
Entity
Organization
Contact information
Practice address
1475 ISLAND AVE UNIT 3605, SAN DIEGO, CA 92101-8251
(858) 790-2334
Mailing address
705 SIERRA LN, FLOWER MOUND, TX 75028-7186
(858) 790-2334
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
08/25/2025
Last updated
08/27/2025
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